Proanthocyanidins-Based Synbiotics as a Novel Strategy for Nonalcoholic Fatty Liver Disease (NAFLD) Risk Reduction

Wasitha P D W Thilakarathna; H P Vasantha Rupasinghe

doi:10.3390/molecules29030709

Proanthocyanidins-Based Synbiotics as a Novel Strategy for Nonalcoholic Fatty Liver Disease (NAFLD) Risk Reduction

Molecules. 2024 Feb 3;29(3):709. doi: 10.3390/molecules29030709.

Authors

Wasitha P D W Thilakarathna¹, H P Vasantha Rupasinghe^{1

2}

Affiliations

¹ Department of Plant, Food, and Environmental Sciences, Faculty of Agriculture, Dalhousie University, Truro, NS B2N 5E3, Canada.
² Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4H7, Canada.

Abstract

Nonalcoholic fatty liver disease (NAFLD), the most common liver disease worldwide, is a spectrum of liver abnormalities ranging from steatosis to nonalcoholic steatohepatitis (NASH) characterized by excessive lipid accumulation. The prevalence of NAFLD is predicted to increase rapidly, demanding novel approaches to reduce the global NAFLD burden. Flavonoids, the most abundant dietary polyphenols, can reduce the risk of NAFLD. The majority of dietary flavonoids are proanthocyanidins (PACs), which are oligomers and polymers of the flavonoid sub-group flavan-3-ols. The efficacy of PAC in reducing the NAFLD risk can be significantly hindered by low bioavailability. The development of synbiotics by combining PAC with probiotics may increase effectiveness against NAFLD by biotransforming PAC into bioavailable metabolites. PAC and probiotic bacteria are capable of mitigating steatosis primarily through suppressing de novo lipogenesis and promoting fatty acid β-oxidation. PAC and probiotic bacteria can reduce the progression of steatosis to NASH mainly through ameliorating hepatic damage and inflammation induced by hepatic oxidative stress, endoplasmic reticulum stress, and gut microbiota dysbiosis. Synbiotics of PAC are superior in reducing the risk of NAFLD compared to independent administration of PAC and probiotics. The development of PAC-based synbiotics can be a novel strategy to mitigate the increasing incidence of NAFLD.

Keywords: flavonoids; nonalcoholic fatty liver disease; nonalcoholic steatohepatitis; proanthocyanidins; probiotic bacteria; steatosis; synbiotics.

Publication types

Review

MeSH terms

Humans
Liver
Non-alcoholic Fatty Liver Disease* / etiology
Non-alcoholic Fatty Liver Disease* / prevention & control
Proanthocyanidins* / pharmacology
Proanthocyanidins* / therapeutic use
Probiotics* / therapeutic use
Synbiotics*

Substances

Proanthocyanidins

Grants and funding

This research received funds from the Discovery Grant of the Natural Sciences and Engineering Research Council (NSERC) of Canada (RGPIN2016 05369) to H.P.V.R.